Kornimate/medical-research-clean huggingface dataset:
correlation of microvascular ophthalmic disease with macrovascular coronary artery disease in trinidad

Conditions: Retinal Disease

Summary: coronary artery disease (cad) is the leading cause of death in trinidad and tobago. early detection and management can help improve morbidity and mortality. retinal artery microvascular disease has been shown to directly correlate with coronary artery disease. retinal artery calibre screening via the optic coherence tomography (oct) will provide a non-invasive method of diagnosing cad.

cardiovascular disease is the number one cause of death in trinidad and tobago. there has been a 20.4% increase in cardiovascular deaths from 2007 to 2017(1). prevention of non-communicable diseases decreases the burden and progression to cardiovascular disease. prevention of death from cardiovascular disease can also be decreased by early detection, intervention and appropriate management of coronary artery disease. due to the burden of the cost of health care on the economy of trinidad and tobago, patients are required to go on a waitlist to receive specialist medical investigation such as a coronary angiogram. this investigation is only offered at one public health facility in trinidad and tobago, the eric williams medical sciences complex. coronary artery disease is graded by a scoring system, the syntax score, which is calculated based on the assessment of the complexity of coronary artery disease by coronary angiography (2). in a study done on 173 patients- the eye-mi study, patients with the lowest retinal vascular density had a higher syntax score, indicating a direct correlation between retinal artery calibre and the severity of coronary artery disease (3). retinal artery calibre is assessed using the optical coherence tomography. it is a relatively affordable non-invasive test performed by an ophthalmologist that allows three dimensional imaging of the retinal vasculature. it is recommended by the american association of ophthalmologist for assessing retinal disease (4). this test is not available in the public health care system in trinidad and tobago. in a country with a human capital index of 0.61 (5), and cardiovascular disease being the number one cause of death, a cheaper non-invasive tool to screen for coronary artery disease would be of benefit to the population. we postulate that there is a direct correlation between the retinal artery calibre assessed by the optical coherence tomography and the severity of coronary artery disease. there are not many studies assessing this relationship and this study will promote further avenues for research into this correlation.

Eligibility criteria:
inclusion criteria: 1. patients 18 years and over, 2. patients who had a coronary angiogram done at the catheterisation lab at the eric williams medical sciences complex during the study period. exclusion criteria: 1. patients who do not give informed consent to participate in the study, 2. patients who are acutely unwell, 3. patients who are symptomatic for coronary artery disease, 4. patients with bilateral cataract.
tips or anticoagulation in portal vein thrombosis

Conditions: Thrombosis Portal Vein

Summary: the progress is an investigator-initiated, multicentre, randomized, trial comparing anticoagulation, which is the currently most frequently used treatment, alone, versus transjugular intrahepatic portosystemic shunt (tips) combined with anticoagulation, in patients presenting with recent obstructive portal vein thrombosis (ropvt). the rationale of this study is to significantly increase the proportion of patients that achieve a complete or partial recanalization of the portal vein. the intervention of this study consists in tips deployment and catheter based clot removal in addition to anticoagulation. the investigators retain that this intervention will increase the proportion of patients with an open portal vein from 38% with anticoagulation alone to 83% with anticoagulation and tips after 6 months. both anticoagulant therapy and clot removal/tips are treatments that are currently available and accepted indications for the treatment of ropvt. anticoagulation will be performed with unfractioned heparin or low molecular weight heparin initially and with vitamin k antagonists in the long term. the investigators plan to collect blood for biobanking at the time of inclusion and after 6 months. blood samples for a biobank will be collected.


Eligibility criteria:
inclusion criteria: 1. recent complete thrombosis of the extrahepatic portal vein either with or without the involvement of intrahepatic branches and with or without involvement of splenic vein and superior mesenteric vein 2. written informed consent exclusion criteria: 1. malignant portal vein thrombosis (neoplastic invasion) 2. intraabdominal malignancy 3. chronic diseases limiting life expectancy in the short term (6 months) 4. liver transplantation 5. unwillingness to participate 6. contraindications to tips (including past or present hepatic encephalopathy grade ≥2) 7. child-pugh-turcotte score 11 or more points in patients with advanced chronic liver disease-
impact of attention deficit/hyperactivity disorder and substance use disorder on motorcycle traffic accidents

Conditions: Attention Deficit Hyperactivity Disorder

Summary: the purpose of this study is to determine whether motorcycle drivers with adhd are at a greater risk for motorcycle accidents, and whether this risk can be mitigated by treatment with methylphenidate. we will evaluate the effectiveness of methylphenidate on driving performance, among motorcycle drivers, and investigate the correlation between improvement of adhd symptoms (inattention and impulsivity) and driving performance.

traffic accidents (car and motorcycle) are the second leading cause of death in 15-34 year-old males. within this group, the prevalence of motorcycle accidents is currently increasing at a significantly higher rate than the prevalence of car accidents, and studies in the international literature suggest that motorcycle drivers comprise a distinct driver profile to car drivers. motorcycles are, by design, more difficult to control, and lend themselves more to performing dangerous stunts. mistakes and lapses in judgment are likely to have more severe consequences when motorcycles are involved, especially when one considers the exposed nature of the driver. this is of special concern in brazil, where a large population of so called "motoboys" delivers almost everything upon request, from food to work documents. it is well known that individuals with adhd have more traffic problems, such as: a higher risk of a car accident; more violent crashes; more traffic violations and a greater chance of losing the driver's license. on a driving simulator, subjects with adhd usually present with more errors and crashes, in comparison to normal controls. treatment with methylphenidate (mph), however, has been shown to improve driving performance on the simulator (for example, subjects significantly reduce their speed when necessary as compared to a placebo group), and this in turn is a good indicator of better real-life driving performance. at present, there are no studies on the effect of adhd treatment with mph specifically on motorcycle drivers. this is relevant, since the increasing prevalence of traffic accidents can attributed to increased incidence of motorcycle accidents. if the treatment proves effective, this study will contribute to a reduction in a major social and health concern.

Eligibility criteria:
inclusion criteria: * professional motorcycle driver * current diagnosis of adhd exclusion criteria: * mental retardation * adhd treatment in the last month * psychosis
quadripolar pacing post approval study

Conditions: Heart Failure

Summary: the purpose of this post-approval study is to evaluate the acute and chronic performance of a quadripolar crt-d device system in a patient population indicated for cardiac resynchronization therapy (crt).

quad pas is a multi-center, post-approval study. patients who meet inclusion/exclusion criteria will have an attempted implant of a quadripolar crt-d device system (device and left ventricular (lv) lead). patients who have an unsuccessful implant will be followed for 30 days for any adverse events and then withdrawn from the study, or may have an implant reattempted if the physician chooses to do so. patients enrolled in the study will be followed at 6 months, and every 6 months thereafter, for 60 months of follow up (5 years). after patients complete 60 months of follow-up, their participation in the study will be terminated.

Eligibility criteria:
inclusion criteria: 1. approved indication per current american college of cardiology/american heart association/heart rhythm society guidelines for implantation of a crt-d system for treatment of heart failure or life threatening ventricular tachyarrhythmia(s). 2. participated in the promote® q crt-d and quartet™ left ventricular heart lead study (investigational device exemption (ide) study), or are receiving a new quadripolar crt-d device system implant or are undergoing an upgrade from an existing implantable cardioverter-defibrillator or pacemaker implant with no prior lv lead placement. 3. have the ability to provide informed consent for study participation and be willing and able to comply with the prescribed follow-up tests and schedule of evaluations exclusion criteria: 1. have a hypersensitivity to a single 1.0mg dose of dexamethasone sodium phosphate 2. have a life expectancy of less than 5 years due to any condition 3. be less than 18 years of age

Keywords: left heart pacing lead cardiac resynchronization therapy (crt) heart failure quadripolar pacing
safety of omitting axillary surgery in breast cancer patients with isolated chest wall recurrence

Conditions: Breast Cancer; Recurrent Disease

Summary: the axillary management of breast cancer patients with operable isolated chest wall recurrence after mastectomy is unclear. we aim to determine if axillary restaging surgery can be safely omitted with no increased recurrences in this group of patients.


Eligibility criteria:
inclusion criteria: mastectomy patients who developed pathologically confirmed invasive isolated chest wall recurrence. - exclusion criteria: -patients with bilateral cancers * patients with evidence of concomitant distant or/and regional recurrences * patients who did not have surgery for their isolated chest wall recurrences.
the effects of surgical wait time for knee arthroplasty quality of life in patients awaiting knee arthroplasty

Conditions: Knee Osteoarthritis

Summary: this study prospectively evaluates the effect of surgical wait time on knee function, pain and quality of life in patients waiting for knee arthroplasty (tka or pka)

osteoarthritis (oa) is a common condition, leading to pain and disability. the knee is the most affected joint, accounting for almost 80 percent of the total prevalence of oa. the pooled global prevalence of knee oa is 22.9% in individuals aged 40 and over. correspondingly, there are around 654.1 million individuals with knee oa in 2020 worldwide. the number of people affected with symptomatic knee oa is likely to increase because of the aging population and the obesity epidemic. pain is the most important symptom in knee oa. it is intermittent, typically weight bearing and progressive over time. additional symptoms are crepitus, swelling and morning stiffness. the knee is often swollen and has diminished range of motion (rom). not only does oa lead to functional disability, but also influences social participation and quality of life. knee oa is a progressive disease, which requires continuous management. treatment consists of conservative as well as invasive treatments, as described in national and international guidelines. first line treatments are patient education, physical therapy, weight loss, different pharmacological treatments and intra-articular steroid injections. more advanced oa may require surgery. knee arthroplasty, (total knee arthroplasty (tka) or partial knee arthroplasty (pka)) can provide excellent pain relief, remarkable deformity correction, and satisfactory functional recovery. since the beginning of the covid19 pandemic, surgeons have been asked to only perform essential surgeries in order to preserve healthcare resources. this has led to an increase in patients on the waiting list, resulting in unusually high wait times. despite the decrease in covid related healthcare consumption, waiting times are yet to return to pre-covid duration. currently, time to surgery in our hospital is approximately 7 months as opposed to 2-3 months pre-covid. long wait times may be a substantial burden for patients. there have been reports of worsening pain, deterioration in quality of life and increased opioid use and frailty. the effects on pain catastrophizing, fear and anxiety have not yet been studied. it is important to better understand the effects of long surgical wait times on pre-operative knee function, pain and quality of life as well as to investigate how this effects outcome after surgery.

Eligibility criteria:
inclusion criteria: * on the waiting list for partial or total knee arthroplasty * written informed consent exclusion criteria: * none

Keywords: knee arthroplasty surgical waiting time waiting list knee pain total knee arthroplasy partial knee arthroplasty knee function quality of life osteoarthritis
the diagnostic and prognostic value of speckle tracking imaging in septic cardiomyopathy

Conditions: Sepsis; Cardiomyopathies; Echocardiography

Summary: the aim of this study is to explore if sti technology, especially tmad, plays an important role in evaluating left ventricular longitudinal systolic function and discriminating sicm in patients with sepsis. the investigators also intend to prove that tmad may have predictive value in patients with sepsis, which is worthy of in-depth study to find strong evidence-based medical evidence for subsequent clinical practical applications.

in order to explore if sti technology, especially tmad, plays an important role in evaluating left ventricular longitudinal systolic function and discriminating sicm in patients with sepsis, the investigators intend to explore that tmad may have predictive value in patients with sepsis, which is worthy of in-depth study to find strong evidence-based medical evidence for subsequent clinical practical applications.

Eligibility criteria:
inclusion criteria: * patients who are diagnosed as sepsis according to sepsis 3.0 criteria exclusion criteria: * patients with history of organic heart disease; * patients with history of heart failure * holder of cardiac implanted device; * patients with history of atrial fibrillation; * refusal to participate in the study
exposure, dose, body burden and health effects of lead

Conditions: Lead Poisoning

Summary: this is a study of the effects that lead has on the health of the central nervous system (for example, memory), peripheral nervous system (for example, sensation and strength in the hands and fingers), kidneys, blood pressure, and the blood forming system. a total of 803 lead workers and 135 persons without occupational lead exposure are being studied in south korea. lead in the body is being assessed by measurement of blood lead, chelatable lead (an estimate of lead in the tissues), and lead in bone. subjects are tested three times each over three years. several genetic factors are also being assessed for the role they play in the health effects of lead. these genes are known to differ among individuals. we are interested to know whether different forms of the same genes can modify the effect lead has on health.


Eligibility criteria:
lead workers in south korea in one of 26 specific lead-using facilities. population controls in south korea.

Keywords: lead poisoning central nervous system peripheral nervous system occupational health genetic susceptibility
current status of treatment for chinese patients with esr1-mutated hr+/her2-advanced breast cancer

Conditions: ESR1 Gene Mutation; Advanced Breast Cancer

Summary: this is a prospective, non-interventional real-world study to observe the efficacy and safety of different treatment regimens in patients with esr1-mutated hr+/her2-advanced breast cancer after failure of endocrine therapy. epidemiological data, efficacy and safety measures will be collected for each subject. data on efficacy and safety assessment indicators will be collected every 2-3 months until disease progression, receipt of a new anti-tumour treatment modality, death, loss to follow-up, and arrival at the data collection cut-off date. the cut-off date for data collection is defined as 8 weeks after completion of 6 visits for each subject, or 4 weeks after treatment discontinuation and subject discontinuation/withdrawal. subjects receiving a different treatment regimen remained subject to assessment of safety indicators 4 weeks after discontinuation of the original treatment regimen.


Eligibility criteria:
inclusion criteria: * 1. must have a histologically or cytologically confirmed diagnosis of breast cancer with evidence of locally advanced disease unsuitable for excision or radical radiotherapy, or evidence of metastatic disease unsuitable for radical treatment. * 2. female ≥ 18 years of age * 3. female subjects must be postmenopausal (meeting any of the following criteria is sufficient) a) has undergone oophorectomy. b) age ≥ 60 years. c) 40 years old \< age ≤ 60 years old with 1 year of menopause. d) age \<60 years and receiving ovarian suppression therapy. * 4. er-positive and her2-negative status and esr1-mutation positive must be confirmed. * 5. must have progressed on at least one line of endocrine therapy prior to enrollment, including monotherapy or combination therapy. * 6. have normal organ function (as assessed by the investigator). exclusion criteria: * 1. women who are pregnant or breastfeeding * 2. known difficulties in tolerating oral medications, or conditions that interfere with the absorption of oral medications or allergies to medications and their excitements * 3. other conditions that make enrollment in the study unsuitable, at the discretion of the investigator
cerebral small vessel disease registry study

Conditions: Cerebral Small Vessel Diseases

Summary: the aim of this study is to determine the clinical spectrum and natural progression of cerebral small vessel disease (csvd) and in a prospective multicenter study, to assess the clinical, genetic and epigenetic features of patients with csvd, , to find independent imaging markers, and to optimize clinical management.


Eligibility criteria:
inclusion criteria: 1. sign informed consent. 2. age\>18 3. at least one of the following csvd mri characteristics: ①recent small subcortical infarct;②lacune of presumed vascular origin;③white matter hypertensity of presumed vascular origin;④perivascular space;⑤cerebral microbleeds;⑥brain atrophy exclusion criteria: 1. unable to cooperate with inspectors 2. non-vascular white matter lesions 3. other cognitive diseases (such as alzheimer's disease, parkinson's disease or thyroid disease) 4. serious systemic illness, such as heart, liver, kidney disease or major mental illness 5. contraindications for imaging examination
human brown adipose tissue and mitochondrial respiration

Conditions: Mitochondrial Metabolism Disorders; Adipose Tissue, Brown; Aging; Obesity

Summary: this study is focused on measuring mitochondrial activity of human brown adipose tissue. during surgery, adipose tissue biopsies from white and brown adipose tissue will be collected from the deep neck area. these biopsies will be used to examine mitochondrial function via histological analysis, biochemical analysis and in vitro experiments based on precursor cells present in the biopsies.


Eligibility criteria:
inclusion criteria: * indication for surgery in the supraclavicular and neck region (more specific patients diagnosed with hyperparathyroidism, struma, benign thyroid gland tumours, implantation of a vagal neurostimulator for epilepsia and cervical neurologic disorders) * in the thyroid gland group, euthyroid function exclusion criteria: * pre-operatively diagnosed malign tumour * patients undergoing acute surgery because of critical illness
ctdna for early response assessment in pcnsl treated with 1st line curative intent (nlg-pcnsl-01)

Conditions: Primary Central Nervous System (CNS) Lymphoma

Summary: this is an international, prospective, multicenter trial with the aim of characterizing circulating tumor dna (ctdna) for early response assessment in pcnsl patients treated with standard of care (soc) 1st line therapy with a curative intent (figure 1). secondary endpoints are to assess the clinical characteristics, health-related quality of life (hrqol), neurological status, and outcome of newly diagnosed primary central nervous system lymphoma (pcnsl) patients in the nordic countries. patients eligible for a curative intent soc 1st line therapy, such as matrix + high-dose chemotherapy and autologous stem cell transplantation (hdct/asct), are eligible for the trial. diagnostic tumor tissue, cerebrospinal fluid (csf), and plasma samples are collected for ctdna and translational analyses with the aim describing new prognostic and predictive biomarkers. treatment responses are assessed with the international pcnsl collaborative group (ipcg) response criteria, and diagnostic and response assessment magnetic resonance imaging (mri) images are centrally analyzed in order to describe new prognostic and predictive markers.


Eligibility criteria:
inclusion criteria: * age 18-70 years at diagnosis * histologically or cytologically verified diffuse large b-cell lymphoma (dlbcl) of the central nervous system (cns) * no prior treatment for pcnsl (pre-treatment corticosteroids are allowed and recommended) * fit for standard of care (soc) 1st line therapy with a curative intent such as full-dose matrix, according to local policy * able to give voluntary written informed consent * if the patient is temporarily incapacitated to give the voluntary written informed consent, due to pcnsl, the informed consent can be obtained from a legally acceptable representative, according to the international conference on harmonisation of technical requirements for registration of pharmaceuticals for human use - guideline for good clinical practice (ich-gcp) guidelines exclusion criteria: * lymphoma outside the cns * history of prior hematological malignancy e.g. low grade b-cell lymphoma * psychiatric illness or condition, other than pcnsl, which could interfere with the ability to understand the requirements of the study

Keywords: pcnsl ctdna